Clinical outcomes of cancer patients with pre-existing autoimmune thyroid disease treated with PD-(L)-1 inhibitors: a propensity score methodology with inverse probability of treatment weighting retrospective study - Report - MDSpire
Advertisement
Clinical outcomes of cancer patients with pre-existing autoimmune thyroid disease treated with PD-(L)-1 inhibitors: a propensity score methodology with inverse probability of treatment weighting retrospective study
Outcomes in Cancer Patients with Prior Autoimmune Thyroid Disorders
Overview
This study investigates the impact of preexisting thyroid antibodies on the incidence of thyroid-related immune adverse events (irAEs) and overall survival (OS) in cancer patients treated with PD-(L)1 inhibitors. Findings indicate that patients with thyroid antibodies have a significantly higher risk of thyroid irAEs but no difference in OS compared to those without antibodies.
Background
Immune checkpoint inhibitors (ICIs) have transformed cancer therapy, yet they can lead to immune-related adverse events, particularly thyroid dysfunction. Understanding the role of preexisting autoimmune conditions, such as thyroid disorders, is crucial as these patients are often excluded from clinical trials due to concerns about severe irAEs. Clarifying the relationship between thyroid autoantibodies and treatment outcomes is essential for optimizing patient management.
Data Highlights
Group
Incidence of Thyroid irAEs
Hazard Ratio (HR)
p-value
Thyroid Ab Positive (N=80)
Higher incidence
4.13 (95% CI: 2.69-6.35)
< 0.001
Thyroid Ab Negative (N=505)
Lower incidence
-
-
Key Findings
Patients with preexisting thyroid antibodies had a higher incidence of thyroid irAEs (HR = 4.13).
Grade≥2 irAEs were significantly more common in antibody-positive patients (HR = 7.54).
No significant difference in overall survival was observed between antibody-positive and negative groups (log-rank p = 0.5).
Patients with thyroid irAEs showed improved survival outcomes (log-rank p = 0.027).
Landmark analysis indicated lower mortality rates for patients developing thyroid irAEs within the first 12 months.
Clinical Implications
Clinicians should be aware that preexisting thyroid antibodies significantly increase the risk of thyroid irAEs in patients receiving ICIs. Despite this increased risk, the development of thyroid irAEs may correlate with improved survival outcomes, suggesting a complex interplay between immune activation and treatment efficacy.
Conclusion
Preexisting thyroid antibodies are a critical factor in predicting thyroid irAEs among cancer patients treated with ICIs, and their presence may be associated with better survival outcomes, highlighting the need for careful monitoring and management in this patient population.
